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Question

Difficulty: MediumCoping Mechanisms

A client in an outpatient clinic is informed by the healthcare provider that their declining vision requires them to surrender their driver's license. After the provider exits the room, the client slams a magazine onto the table and yells at the nurse, "You kept me waiting in the lobby for an hour! The staff here is completely incompetent!" Which response by the nurse is the most therapeutic?

  1. A
    Why are you angry with the nursing staff when the provider gave you the news?
  2. You seem very upset. Tell me more about how you are feeling right now.Answer
  3. C
    Everything will work out fine because the city has excellent transportation services for seniors.
  4. D
    It is important that you listen to the provider because driving with impaired vision puts others at risk.

Answer

The most therapeutic response validates the client's emotional distress and uses an open-ended statement to encourage them to talk about their feelings.
The client is demonstrating the defense mechanism of displacement by directing their frustration about the loss of their driving privileges toward the nurse. The most therapeutic approach is to acknowledge the client's emotional state and use an open-ended statement to encourage them to express their true feelings, which de-escalates the situation and builds trust.

Step-by-Step Solution

1
Analyze the client's behavior and underlying emotions.
The client is demonstrating displacement by redirecting their anger and grief about losing their driver's license onto the clinic staff.
Recognizing the defense mechanism helps the nurse understand that the anger is not a personal attack, but a coping response to sudden loss.
2
Evaluate the nursing responses based on therapeutic communication principles.
The nurse must address the client's emotional state rather than reacting defensively to the misplaced anger or trying to fix the problem prematurely.
Therapeutic communication focuses on the client's immediate psychological needs.
3
Select the response that facilitates the expression of feelings.
Acknowledging that the client is upset and inviting them to share more is the best choice.
This approach builds trust and helps the client process the distressing news.

Key Concept

Displacement and Therapeutic Communication
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Topics

Coping Mechanisms

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